Abstract
Background
CD8+ tumor-infiltrating lymphocytes (TILs) have emerged as a prognostic indicator in triple-negative
breast cancer (TNBC). There is debate surrounding the prognostic value of hot spots
for CD8+ TIL enumeration.
Methods
We compared hot spot versus whole-tumor CD8+ TIL enumeration in prognosticating TNBC using immunohistochemistry on whole tissue
sections and quantification by digital image analysis (Halo imaging analysis software;
Indica Labs, Corrales, NM). A wide range of clinically relevant hot spot sizes was
evaluated.
Results
CD8+ TIL enumeration was independently statistically significant for all hot spot sizes
and whole-tumor annotations for disease-free survival by multivariate analysis. A
10× objective (2.2 mm diameter) hot spot was found to correlate significantly with
overall survival (P = .04), while the remaining hot spots and whole-tumor CD8+ TIL enumeration did not (P > .05). Statistical significance was not demonstrated when comparing between hot
spots and whole-tumor annotations, as the groups had overlapping confidence intervals.
Conclusion
CD8+ TIL hot spot enumeration is equivalent to whole-tumor enumeration for prognostication
in TNBC and may serve as a good alternative methodology in future studies and clinical
practice.
Keywords
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Article info
Publication history
Published online: May 07, 2018
Accepted:
April 27,
2018
Received in revised form:
April 17,
2018
Received:
January 3,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
